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[胸部创伤 - 院前治疗]

[Thoracic Trauma - Prehospital Treatment].

作者信息

Hansen Michael, Hachenberg Thomas

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2017 Jun;52(6):408-421. doi: 10.1055/s-0042-118056. Epub 2017 Jun 14.

Abstract

Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful. The selection of trauma center depends on the severity of the trauma, if necessary with the availability of extracorporeal circulation.

摘要

穿透性胸部损伤在德国较为罕见,在城市地区较为常见。急诊科10%的患者患有钝性胸部创伤。创伤机制可以预测损伤的严重程度。必须诊断出伴有血流动力学问题的极快速危及生命的损伤,如张力性气胸或心脏压塞。院前急救医生需要具备超声诊断技能以及胸腔闭式引流管或心包引流管等侵入性治疗技能。应用算法来探查胸部创伤似乎是有用的。创伤中心的选择取决于创伤的严重程度,必要时还需考虑体外循环的可用性。

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